A medical emergency leads to big bills and valuable days of work lost.

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A payday loan may bring thousands of dollars in interest or overdraft fees.

For those struggling to make ends meet, everyday costs come laden with traps that can drag impoverished people and families over a financial precipice.

In other words: Life gets expensive in a hurry for those who can least afford it.

Sharon Kleeman, director of Presentation Partners in Housing, said costs ranging from routine to major can be pitfalls for people getting by on little income.

It might be something as simple as car insurance - something many low-income drivers skip because it's a low priority. If those drivers get pulled over, they incur fines they can't pay. When the fines go unpaid, they escalate, driving already-struggling people deeper into a hole.

A similar trap can occur with rent and mortgages. Late rent leads to late fees - sometimes accrued by the day - which further punish those who already can't afford it.

"It just kind of snowballs," said Kleeman, whose group helps families dealing with housing crises.

And unexpected costs, like medical emergencies, are a major stumbling block. Medical bills balloon quickly, even for people with insurance, and can lead to huge debts and garnished wages.

For Kelly, a 27-year-old mother of two young children who lives in Moorhead, a serious illness was the catalyst for financial trouble that began this summer. She and her husband didn't have the savings to cover medical bills and travel costs to medical centers that totaled thousands of dollars and counting, even with insurance.

Those expenses, along with a few other unexpected costs over the summer and a reduction in her husband's hours at work, put her family behind. She and her husband are now paying half their mortgage in the middle of the month instead of all up front, which adds a late charge.

"For us, that's a pack of diapers for our children," said Kelly, who asked that her last name not be printed.

Duane Emmel, a credit counselor for the Financial Resource Center at The Village in Fargo, said that emergency expenses like the ones Kelly faced are a big problem for families who don't have much margin for extra costs.

"If my budget is already tight and my dollars are pretty well spoken for, then it becomes very difficult," he said. "You don't have a lot of ability to address the emergencies that come up in a lot of places."

He said options for borrowing money to make ends meet - credit cards, payday loans - can put people further behind.

Kleeman said payday loans can trap financially strapped borrowers in two ways: They might either roll over the loan at high interest rates when they can't pay it back or get hit with overdraft fees when the repayment exceeds their checking accounts.

"I've had people come to me with checking accounts of minus $2,000 on maybe a $500 payday loan that they couldn't take care of," she said.

Kelly and her husband borrowed money from a family member to make ends meet this summer.

"I don't think we'll ever get caught up on that," she said. "It's just a never-ending cycle, it seems."

When Kelly was a child, her family lost their home. She's determined not to put her children through the same thing and has worked with Kleeman to get help on her mortgage. She said the feeling of being behind is a frustrating one.

"We're just sitting here, spinning our wheels and not being able to get caught up," she said.

"Joy," another 27-year-old with two children, knows the feeling. She was her family's primary breadwinner until she lost her job in October, which left the family struggling with everything from the energy bill to groceries.

She and her husband have incurred late fees on credit card debt, and she's not sure how they're going to make rent next month.

"It's very stressful," said Joy, who asked The Forum not to use her real name. "It just doesn't stop."

Like Kelly, Joy is working with Kleeman and other agencies to get help. They've tried to cut expenses where they can, but face tough choices. If they cut out day care, Joy is occupied with the children instead of looking for work. If they cut out her phone, potential employers have no way of reaching her.

Even when she was employed, she said it was tough to care for a family on take-home pay for about $2,000 a month. And even though she holds a master's degree in business administration, she's applying for many jobs that pay less than $9 an hour.

Kleeman said it's not impossible to turn things around. She's seen clients get their affairs in order, get the help they need, and climb out of trouble.

But she also cautioned that things can still fall apart. She remembers one client who got back on her feet and was doing well when she last checked on her.

"That doesn't mean I'm never going to hear from her again," she said. "You think they're doing OK, and then a year later, you hear from them again."

Eccher is a reporter for The Forum of Fargo-Moorhead. The Bemidji Pioneer and Forum are both Forum Communications Co. newspapers.